Lack of resolution of ectopic pregnancy by intratubal injection of methotrexate

Mottla, Gilbert L.; Rulin, Marvin C.; Guzick, David S.

doi:10.1016/s0015-0282(16)54922-x

Cited by 44 publications

(9 citation statements)

References 5 publications

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“…Laparoscopic salpingostomy has been compared with methotrexate injected laparoscopically, [14][15][16] with methotrexate injected transvaginally, 17 and with hyperosmolar glucose injected laparoscopically. 18 However, the comparison of a complete non-surgical and non-invasive treatment by the systemic administration of methotrexate with laparoscopic salpingostomy was lacking until our randomised clinical trial.…”

Section: Discussionmentioning

confidence: 99%

Randomised trial of systemic methotrexate versus laparoscopic salpingostomy in tubal pregnancy

Hajenius

Engelsbel

Mol³

et al. 1997

The Lancet

239

115

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General rightsIt is not permitted to download or to forward/distribute the text or part of it without the consent of the author(s) and/or copyright holder(s), other than for strictly personal, individual use, unless the work is under an open content license (like Creative Commons). Disclaimer/Complaints regulationsIf you believe that digital publication of certain material infringes any of your rights or (privacy) interests, please let the Library know, stating your reasons. In case of a legitimate complaint, the Library will make the material inaccessible and/or remove it from the website. Interpretation In haemodynamically stable patients with unruptured tubal pregnancy, systemic methotrexate and laparoscopic salpingostomy were successful in treating the majority of cases. We found no significant difference between the treatments in the homolateral patency rate. Subsequent fertility outcome has to be awaited to show which treatment yields better fertility prospects.

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Section: Discussionmentioning

confidence: 99%

Randomised trial of systemic methotrexate versus laparoscopic salpingostomy in tubal pregnancy

Hajenius

Engelsbel

Mol³

et al. 1997

The Lancet

239

115

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show abstract

“…Varios protocolos experimentales de tratamiento local del EET, no han demostrado ser más eficientes que la salpingostomía laparoscópica, como por ejemplo el uso de metotrexato local bajo guía ecográfica (42), o bajo guía laparoscópica (43)(44)(45). También se ha utilizado glucosa hiperosmolar local (46,47) y prostaglandinas (48).…”

Section: Discussionunclassified

Rol De La Cirugía Endoscópica en El Manejo Actual Del Embarazo Ectópico Tubárico

G¹,

P²

2005

Rev. chil. obstet. ginecol.

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RESUMENSe presenta una experiencia local de cirugía laparoscópica en el embarazo ectópico tubárico, y basado en la literatura, se discute su rol actual entre diferentes tipos de tratamiento: el quirúrgico, el médico, y la conducta expectante. Se analizan los efectos de estos regímenes en función del éxito del tratamiento, la necesidad de reintervención, la permeabilidad tubárica y fertilidad futura. PALABRAS CLAVE: Embarazo ectópico tubárico SUMMARYWe report our experience in laparoscopy surgery in the treatment of tubal pregnancy. Various types of treatments are available: surgical, medical and expectant management. In this review the effects of various treatment are summarized in terms of treatment success, need for reinterventions, tubal patency and future fertility. KEY WORDS: Ectopic tubal pregnancy Trabajos Originales INTRODUCCIÓNLa incidencia del embarazo ectópico tubárico (EET) ha ido en aumento durante las últimas dé-cadas. Esto es debido al advenimiento de los métodos anticonceptivos y la liberación sexual de la mujer que, juntos, llevaron a un incremento en los casos de enfermedad inflamatoria pélvica (EIP) y trajo como una de sus consecuencias el EET. Además del incremento de la EIP, las cirugías de trompas y otros procedimientos para tratar la infertilidad contribuyeron sobremanera con este aumento (1).En la actualidad el médico cuenta con muchas opciones terapéuticas para el EET: el tratamiento quirúrgico, que puede ser radical o conservador, por laparoscopia o mediante laparotomía; tratamiento médico, con diversos fármacos, que se pueden administrar por vía sistémica o local, y la conducta expectante.El diagnóstico de embarazo ectópico se puede hacer con métodos no invasivos, como las pruebas de embarazo en suero, con cuantificación de subunidad beta de gonadotropina coriónica humana (β-HCG), desde 1500 UI/l, y con ultrasonido transvaginal de alta resolución. Por consiguiente, la presentación clínica del embarazo ectópico ha dejado de ser una amenaza para la vida de la mujer, para convertirse en una patología más benigna; esto a su vez, ha dado como resultado cambios importantes en las opciones disponibles para su manejo terapéutico (2-4).La cirugía conservadora es el procedimiento de elección para pacientes que deseen una fertilidad futura, definida como el tiempo transcurrido desde el EET hasta un embarazo intrautrauterino

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“…Feichtinger was the first to describe the use of transvaginally guided needle puncture to treat the ectopic tubal gestation [29]. Since then, several centers have used this modality as an additional tool in treatment of patients with ectopic pregnancy [28,[30][31][32][33]. One complication that may occur is concurrent or delayed hemorrhage.…”

Section: Conservative Management Of Ectopic Pregnancymentioning

confidence: 99%

Guided procedures using transvaginal sonography

Kupešić

Ahmed

2005

The Ultrasound Review of Obstetrics & Gynecology

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Transvaginal sonography is indispensable for monitoring of follicular growth and is used for aspirating the follicular fluid for oocyte retrieval. Its use has itnproved the accuracy of etnbr\'o replacement into the utetnjs, or via the uterus, into the Fallopian tube and guidance of Fallopian-tube catheterization. Other ultrasonically guided procedures analyzed in this review article are aspiration of the ovarian cysts, drainage of cul-de-sac abscesses and selective reduction of multiple pregnancies. The advantages of ultrasonically guided transvaginal procedures are their performance under real-time imaging, relative simplicity, and low procedure-related complication rate. Most of these procedures can be performed in an office or emergency-room setting, but some require carefully monitored hospital protocols.

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Lack of resolution of ectopic pregnancy by intratubal injection of methotrexate

Cited by 44 publications

References 5 publications

Randomised trial of systemic methotrexate versus laparoscopic salpingostomy in tubal pregnancy

Randomised trial of systemic methotrexate versus laparoscopic salpingostomy in tubal pregnancy

Rol De La Cirugía Endoscópica en El Manejo Actual Del Embarazo Ectópico Tubárico

Guided procedures using transvaginal sonography

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